

<html>
<head>
<title>Owner Details</title>
<jsp:include page="header.jsp" />
</head>
<script type="text/javascript" src="template/js/page/ownerDetail.js">
	
</script>
<body>
	<fieldset>
		<legend>Owner Details</legend>
		<form method="post" name="vechilDetail" onsubmit="return validation()"
			action="register">
			<input type="hidden" name="action" value="owner-details-register" />
			<table align="center">
				<tr>
					<td>Name</td>
					<td><jsp:useBean id="personalDetailsDto" scope="session"
							type="com.pks.autoInsurance.dto.PersonalDetailsDto" />
						${personalDetailsDto.firstName }</td>
					<td></td>
				</tr>
				<tr>
					<td>SSN&nbsp;<font color="red">*</font>
					</td>
					<td><input name="ssn" type="text" />
					</td>
					<td><span class="serr" id="ssnNo"> </span>
					</td>
				</tr>
				<tr>
					<td>Blood Group</td>
					<td><SELECT name="bloodGroup">

							<OPTION value="O+">O+</OPTION>
							<OPTION value="O-">O-</OPTION>
							<OPTION value="A+">A+</OPTION>
							<OPTION value="A-">A-</OPTION>
							<OPTION value="B+">B+</OPTION>
							<OPTION value="B-">B-</OPTION>
							<OPTION value="AB+">AB+</OPTION>
							<OPTION value="AB-">AB-</OPTION>
					</SELECT>
					</td>
					<td></td>
				</tr>
				<tr>
					<td>Driving License &nbsp;<span class="serr">*</span>
					</td>
					<td><input name="drivingLicence" type="text" />
					</td>
					<td><span class="serr" id="driving"> </span>
					</td>
				</tr>
				<tr>
					<td>No of Accident</td>
					<td><SELECT name="totalAccident">

							<OPTION value="1">1</OPTION>
							<OPTION value="2">2</OPTION>
							<OPTION value="3">3</OPTION>
							<OPTION value="4">4</OPTION>
							<OPTION value="5">5</OPTION>
							<OPTION value="6">6</OPTION>
							<OPTION value="7">7</OPTION>
					</SELECT>
					</td>
					<td></td>
				</tr>
				<tr>
					<td>&nbsp;</td>
					<td><input type="submit" value="Proceed" />
						&nbsp;&nbsp;&nbsp; <input type="reset" value="Reset" />
					</td>
					<td></td>
				</tr>
				<tr>
					<td></td>
					<td><hr>
					</td>
				</tr>
				<tr>
					<td></td>
					<td><span class="serr"><sub> * Must be
								Alpha-Numeric</sub>
					</span>
					</td>
				</tr>
				<tr>
					<td></td>
					<td><font color="red"><sub>SSN must be of 6
								characters</sub>
					</font>
					</td>
				</tr>
				<tr>
					<td></td>
					<td><font color="red"><sub>Driving License must
								be of 6 characters</sub>
					</font>
					</td>
				</tr>
			</table>
		</form>
	</fieldset>
	<jsp:include page="footer.jsp" />
</body>
</html>